| Seizures, Focal
Afinitor vs Fycompa
Side-by-side clinical, coverage, and cost comparison for seizures, focal.Deep comparison between: Afinitor vs Fycompa with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsFycompa has a higher rate of injection site reactions vs Afinitor based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Fycompa but not Afinitor, including UnitedHealthcare
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Category
Afinitor
Fycompa
At A Glance
Oral
Daily
mTOR inhibitor
Oral
Once daily
AMPA receptor antagonist
Indications
- Hormone receptor positive breast cancer
- Neuroendocrine tumor of pancreas
- Gastro-enteropancreatic neuroendocrine tumor
- Renal Cell Carcinoma
- Angiomyolipoma of kidney
- Subependymal Giant Cell Astrocytoma
- Seizures, Focal
- Seizures, Focal
- Tonic-Clonic Epilepsy
Dosing
Hormone receptor positive breast cancer 10 mg orally once daily in combination with exemestane until disease progression or unacceptable toxicity.
Neuroendocrine tumor of pancreas, Gastro-enteropancreatic neuroendocrine tumor 10 mg orally once daily until disease progression or unacceptable toxicity.
Renal Cell Carcinoma 10 mg orally once daily until disease progression or unacceptable toxicity.
Angiomyolipoma of kidney 10 mg orally once daily until disease progression or unacceptable toxicity.
Subependymal Giant Cell Astrocytoma Starting dose 4.5 mg/m2 orally once daily (AFINITOR or AFINITOR DISPERZ); titrate to trough concentration 5-15 ng/mL.
Seizures, Focal Starting dose 5 mg/m2 orally once daily (AFINITOR DISPERZ); titrate to trough concentration 5-15 ng/mL.
Seizures, Focal Start at 2 mg once daily at bedtime; increase by 2 mg no more frequently than weekly; recommended maintenance 8-12 mg once daily at bedtime (monotherapy or adjunctive). With concomitant moderate or strong CYP3A4 inducers, start at 4 mg once daily.
Tonic-Clonic Epilepsy Start at 2 mg once daily at bedtime; increase by 2 mg no more frequently than weekly; recommended maintenance 8 mg once daily at bedtime (adjunctive). With concomitant moderate or strong CYP3A4 inducers, start at 4 mg once daily.
Contraindications
- Clinically significant hypersensitivity to everolimus or other rapamycin derivatives
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Adverse Reactions
Most common (>=30%) Stomatitis, infections, rash, fatigue, diarrhea, decreased appetite.
Serious Non-infectious pneumonitis, infections, severe hypersensitivity reactions, angioedema, stomatitis, renal failure, impaired wound healing, metabolic disorders (hyperglycemia, dyslipidemia), myelosuppression, radiation sensitization and recall.
Postmarketing Thrombotic microangiopathy, cardiac failure (including with pulmonary hypertension), acute pancreatitis, cholecystitis, cholelithiasis, sepsis, reflex sympathetic dystrophy, arterial thrombotic events, lymphedema, radiation sensitization and recall.
Most common (>=4%) dizziness, somnolence, fatigue, irritability, falls, nausea, ataxia, balance disorder, gait disturbance, vertigo, weight gain
Serious serious psychiatric and behavioral reactions, suicidal behavior and ideation, neurologic effects, falls, DRESS/multiorgan hypersensitivity
Postmarketing DRESS, acute psychosis, hallucinations, delusions, paranoia, delirium, confusional state, disorientation, memory impairment
Pharmacology
Everolimus is an mTOR inhibitor that binds the intracellular protein FKBP-12 to form an inhibitory complex with mTORC1, suppressing downstream effectors (S6K1, 4E-BP1) involved in protein synthesis, cell proliferation, and angiogenesis, and reducing HIF-1 and VEGF expression; mTOR pathway dysregulation occurs in several human cancers and in tuberous sclerosis complex.
Perampanel is a non-competitive antagonist of the ionotropic AMPA glutamate receptor on post-synaptic neurons, reducing neuronal over-excitation caused by glutamate, the primary excitatory neurotransmitter in the CNS; the precise mechanism by which it exerts antiepileptic effects in humans is unknown.
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Most Common Insurance
Anthem BCBS
Afinitor
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (0/12)
Fycompa
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (1/12) · Qty limit (9/12)
UnitedHealthcare
Afinitor
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (6/8)
Fycompa
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Afinitor
- Covered on 0 commercial plans
- PA (2/3) · Step Therapy (0/3) · Qty limit (2/3)
Fycompa
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (3/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Afinitor.
$5/momo
Fycompa Instant Savings Card - Covered benefitCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Final cost depends on formulary coverage
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.